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This document describes a case study of a rare cause of dementia in a 62-year old male patient. The patient had been experiencing memory, thinking, speaking, swallowing, and balance difficulties for two years. A neurological examination revealed dysarthria, opthalmoplegia, dysphagia, rigidity, and weight loss. MRI scans showed diffuse ischemic focuses and midbrain atrophy characteristic of Progressive Supranuclear Palsy (PSP), an uncommon cause of dementia. Based on the clinical symptoms and MRI findings, PSP was diagnosed as the cause of the patient's dementia.
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- 1. Case of patient with a rare cause of dementia Students: Natalia Fornal, Dominik Grzebyk Scientific supevisor: dr n. med. Joanna Bielewicz Students’ Scientific Society, Departament of Neurology, Medical University of Lublin, Poland
- 2. BACKGROUND Dementia • often progressive • mainly affects the elderly • risk for dementia- aging, smoking, diabetes, hypertension, alcohol term to describe a set of symptoms, characterized by a cognitive disturbance
- 3. BACKGROUND Manifestation of Dementia • memory insufficiency • problems with thinking, orientation, learning and problem solving, • ability to focus and pay attention • worsening of control emotions • behavioral changes • reduced motor function
- 4. BACKGROUND • up to half of people ages 85 and older may have Alzheimer’s disease- most common cause of dementia • vascular dementia, • Lewy body disease • frontotemporal dementia • about 46 million people in 2015 afected
- 5. BACKGROUND • neurodegenerative (tauopathy) • slowly progress • unknown cure • diagnosed late nonspecific signs Uncommon cause of dementia is Progessive Supranuclear Palsy (PSP)
- 7. CASE REPORT • to diagnose increasing cognitive disturbances Symtopms from last two years: • memory, thinking and performance disturbances • patient also complained to speaking, swallowing and balance difficulties 62 years old male patient was admitted to Neurological Clinic in July 2017
- 8. CASE REPORT CURRENT NEUROLOGICAL EXAMINATION dysartria opthalmoplegia with impaired vertical movement dysphagia rigidity, especially in right side In last two months patient lost 5 kg weight
- 9. CASE REPORT MMSE-16 Clock Drawing test 0/10 difficulties in calculation and writing difficulties in attention and concentration Psychological examination severe cognitive impairment
- 10. CASE REPORT MRI detected • diffuse ischemic focuses • atrophy of the midbrain (mainly in tegmentum) characteristic Hummingbird sign Another tests, clinical examination excluded other causes of dementia, CNS inflammatory diseases and paraneoplasmatic syndroms Clinical symptoms and MRI proved PSP diagnosis
- 12. „Hummingbird ” sign or „Pinguin” sign
- 13. CONCLUSIONS • dementia is very common in neurological practice • it is necessary to control patients with dementia regulary • occuring of a new symptoms, which are not connected with dementia, should determine extension of examination • it is important to take into consideration another uncommon causes of dementia
- 14. Thank You for Your attention!
Editor's Notes
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577/